Comparison of Different Radiotherapy Techniques for Locally Advanced Pancreatic Tumors

Abstract

Radiotherapy (RT) associated with systemic therapy is the standard treatment for Locally Advanced Pancreatic Cancer (LAPC). The aim of this study was to compare the efficacy of different RT techniques using the clinical data reported in the literature. Clinical data was collected from scientific papers searched in the databases PubMed and ScienceDirect. Thirty-four documents published between 1997 and 2015 were found and met the inclusion criteria: locally advanced adenocarcinoma, unresectable and no metastasis. Values of Complete Response (CR), Partial Response (PR), Stable Disease (SD), Progression Disease, Progression Free Survival (PFS), and Overall Survival (OS) for Three-Dimensional Conformal Radiation Therapy (3DCRT), Intensity Modulated Radiation Therapy (IMRT) and Stereotactic Body Radiotherapy (SBRT) in the treatment of LAPC were collected. For all RT techniques, Response Rate (RR), defined as the sum of CR and PR, was for 3DCRT 25.2% ± 9.5 [range: 5.0%–49.0%], for IMRT 33.5% ± 10.5 [range: 10.6%–55.6%] and for SBRT 52.2% ± 17.7 [range: 13.3%–69.5%]. For all studied techniques, Local Control (LC), defined as the sum of RR and SD, ranged from 47% to 100%; PFS ranged from 4 to 12 months and OS ranged from 6 to 20 months. A significant improvement in overall response rate was obtained with SBRT compared to 3DRCT and IMRT. However, LC, PFS and OS were similar among the three RT techniques.